The Consistency of Cardiac Output Measurements by Different Methods in VA-ECMO Patients
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 20
- 试验地点
- 1
- 主要终点
- Cardiac Output measurement after Dobutamine stress test
研究概览
简要总结
Objective：
- To evaluate the consistency of cardiac output measured by different hemodynamic monitoring methods in patients with VA-ECMO
- To evaluate whether different hemodynamic monitoring methods can accurately detect the trend of cardiac output changes
详细描述
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been used for profound cardiogenic shock to bridge to decision,ventricular assist devices,or transplant.Close monitoring of cardiac output, especially in patients before and after intervention (such as volume expansion, diuresis, vasoconstriction, vasodilation therapy), can help to adjust the treatment strategy. Hemodynamic monitoring in ECMO patients requires familiarity with the underlying pathophysiology and circulatory mechanics of extracorporeal flow.Limited to the actual clinical situation of patients, one or two hemodynamic monitoring methods may be accepted. Is there consistency between different hemodynamic monitoring results? And whether hemodynamic monitoring can accurately detect the changes of these parameters before and after intervention is an important issue in clinical practice. This study will provide important reference for VA-ECMO patients how to choose appropriate hemodynamic monitoring tools and how to interpret the results of hemodynamic monitoring.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •cardiac surgery
- •treatment with VA-ECMO
- •mechanical ventilation
- •hemodynamic monitoring according to patient's condition (PAC, Flotrac, echocardiography)
排除标准
- •cardiac arrhythmia
- •moderate to severe aortic, mitral and tricuspid regurgitation
- •active hemorrhage
- •spontaneous triggering of the ventilator
研究组 & 干预措施
Trendelenburg Maneuver
The Trendelenburg position is a common treatment in medicine.It is used either as a diagnostic tool to assess fluid loading response or as a therapeutic maneuver pending fluid resuscitation.With the advantage of autotransfusion readily available,the Trendelenburg position is used for expected instantaneous effect on cardiovascular performance.
干预措施: Trendelenburg Maneuver (Diagnostic Test)
dobutamine stress test
Dobutamine is a selective beta 1 receptor agonist. It [<10 ug/(kg.min)] can effectively increase myocardial contractility.
干预措施: dobutamine stress test (Diagnostic Test)
结局指标
主要结局
Cardiac Output measurement after Dobutamine stress test
时间窗: 5 minutes after dobutamine stress test
Cardiac Output measured after dobutamine stress test
Baseline Cardiac Output measurement
时间窗: within1 minute at baseline position
Cardiac Output measured at baseline position（ in a supine position with the head elevated to 15° for baseline measurements ）
Cardiac Output measurement afterTrendelenburg Maneuver
时间窗: 1 minute after starting Trendelenburg Maneuver
Cardiac Output measured after Trendelenburg Maneuver
次要结局
未报告次要终点